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We support the concept that long-term, prospective, inclusive collection of data on all traumatic ruptured globes is needed to answer the important question of whether refractive surgery that is not medically necessary predisposes the eye to traumatic rupture. Such a study was proposed to leaders of the refractive surgery community, but did not progress further. We believe that these cases indicate only a potential hazard that is underreported in the peer review literature and does not represent a complete case count, thus, cannot be used as a basis to determine the incidence of traumatic RK and hexagonal keratotomy wound rupture.Remember, many of our cases were of eyes ruptured following minor trauma that would not ordinarily cause a globe rupture, let alone loss of an eye.Because every eye ruptured through the RK or hexagonal keratotomy incision as much as 10 years postoperatively, these cases may be a